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Implementing a Delirium Risk Stratification Tool and Rounds to Identify and Prevent Delirium in Hospitalized Older
Tru Byrnes1, Jennifer Woodward
1Carolinas Medical Center, Charlotte, North Carolina (Dr Byrnes); and Geriatric Medicine CHS Senior Care, Charlotte, North Carolina (Dr Woodward).
Background:
Up to 40% of delirium cases are preventable, and early identification is key to improve patient outcomes.
Purpose:
To implement and evaluate a multidisciplinary delirium intervention program.
Intervention:
The delirium intervention program targeted patients at high risk for delirium and included patient and nurse education, risk stratification, multidisciplinary rounds, a nonpharmacological intervention bundle, and a treatment order set.
Results:
After implementation, there was a reduction in length of stay of 6.3 days ( P = .01), a 24% decrease in disposition to a skilled nursing facility ( P = .05), and increased detection of delirium by nurses.
Conclusion:
Positive patient outcomes were achieved by employing a multifactorial approach for delirium identification, prevention, and management. The components of this quality improvement project provide guidance to hospitals seeking to develop a delirium intervention program.
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